The Physician Scientist Award described in this proposal will train the candidate. Dr. Jonathan Javitt, as an independent investigator in epidemiologic problems related to ophthalmic disease. During the training period, Dr. Javitt will focus particularly upon epidemiologic case-control and population based studies in the detection and treatment of glaucoma. The primary training site will be the International Center for Epidemiologic and Prevention Ophthalmology of the Wilmer Ophthalmic Institute, Johns Hopkins University (ICEPO). The committee evaluating Dr. Javitt's progress will be chaired by Dr. Alfred Sommer and composed of Drs. Harry Quigley, Alan Robin, Hugh Taylor, and James Tielsch. The program as outlined will consist of a two year Phase I period followed by a three year Phase II period. During Phase I the candidate will be trained in methodologies of epidemiologic investigation. The two years will include formal coursework at the Johns Hopkins School of Hygiene and research seminars in the Clinical Epidemiology Department of the Johns Hopkins School of Medicine. In order to be trained in techniques of epidemiologic investigation, Dr. Javitt will participate in population based and case control studies in the early detection of glaucoma that are currently in progress at ICEPO. He will use these existing data bases to study risk factors for glaucomatous optic atrophy. During Phase I, Dr. Javitt will execute a field study in China to test the safety and efficacy of laser iridotomy performed with a portable YAG laser as a means of controlling blinding, endemic angle closure glaucoma. Patients who have had a attack of acute angle closure in one eye will be selected and randomly assigned to either laser iridotomy in the fellow eye or to medical management with locally available miotic preparations. The hypothesis to be tested is that laser iridotomy is more effective than the currently employed miotic therapy in preventing angle closure in the fellow eye. Based upon his training and research during Phase I, Dr. Javitt will design two projects to be executed in Phase II of this program. The first will be a population based case control study in the early detection of glaucoma and the analysis of risk factors for glaucomatous optic nerve damage. The second will be a field trail to test the safety and efficacy of YAG laser trabeculoplasty in research and plans for Phase II in a thesis to be presented to his faculty committee. Phase II will consist of a three year full time research period under the supervision of Dr. Javitt's faculty committee. During this phase he will mount the studies designed during Phase I. By the end of Phase II. Dr. Javitt will be qualified as an independent investigator in the epidemiology and treatment of blinding diseases on a population wide level.